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You must use black ink to fill out this form.

Your Name:

Mailing Address:



Telephone: Message phone:

NOTE: If for any reason you do not wish the other party to know your physical address, you must still provide a mailing address so that the court and the other party can serve you by mail.
IN THE SUPERIOR COURT FOR THE STATE OF ALASKA
AT
City or Town where the Court is located

)

)

Plaintiff, )

)


  1. )

)

)

Defendant. )

)

) Your Case No.


INTERIM ORDERS

 Plaintiff  Defendant filed a Motion and Affidavit for Interim Orders on . The opposing party  did did not respond in writing. A hearing  was  was not held on



at which  plaintiff  defendant was/were present.
After considering the Motion and Affidavit for Interim Orders and any opposition thereto, and good cause being found, IT IS HEREBY ORDERED:
1.  ATTORNEY’S FEES & COSTS

 Plaintiff  Defendant shall pay $ , a reasonable amount to obtain legal assistance, to  plaintiff  defendant within days. Other comments:


2.  SPOUSAL and MEDICAL/DENTAL SUPPORT



A.  Plaintiff  Defendant is shall pay  plaintiff  defendant the following as reasonable spousal support:
Amount: How often:  per week  per month

Type of payment: Cash  Check  Other:

Method of payment:  Mail  Deposit  Hand deliver  Other:
B.  Plaintiff  Defendant shall provide available medical and dental insurance to

his/her spouse and shall pay % of all uninsured medical and dental expenses reasonably incurred by his/her spouse.



3.  PROPERTY

A.  Plaintiff shall be granted exclusive use and possession of the following property until further order of this court:

 Residence located at:

 Vehicle described as:

 Other:



B.  Defendant shall be granted exclusive use and possession of the following property until further order of this court:

 Residence located at:

 Vehicle described as:

 Other:


4.  DEBTS


A.  Plaintiff shall pay the following debts until further order of this court:

Debt and name of creditor Monthly Amount Owed











Debts continued:

B.  Defendant shall pay the following debts until further order of this court:
Debt and name of creditor Monthly Amount Owed











5.  OTHER RELIEF

The following additional relief is ordered:


IT IS SO ORDERED.
Dated at , Alaska this _____ day of , 20 .



Judge

I certify that on a copy

of the above was mailed to each of the following:

at their addresses of record. (List names if not an agency)

 Plaintiff / Attorney _____________________________

 Defendant / Attorney __________________________




Deputy Clerk / Secretary




INTERIM ORDERS Page of 3

(No minor child(ren) SHC-1107 (4/05)




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